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Exploring The Impact Of Maternal Early Life Adversity On Interoceptive Sensibility In Pregnancy: Implications For Prenatal Depression, Paul W. Savoca, Laura M. Glynn, Molly M. Fox, Misty C. Richards, Bridget L. Callaghan

Psychology Faculty Articles and Research

Purpose

Pregnancy is a sensitive period of development in adult life characterized by massive changes in physical, emotional, and cognitive function. Such changes may be adaptive, e.g., facilitating adjustment to physical demands, but they may also reflect or contribute to risks inherent to this stage of life, e.g., prenatal depression. One cognitive ability that may undergo change during pregnancy and contribute to mental wellness is interoception - the ability to perceive, integrate, and model sensory information originating from the body. Strong interoceptive abilities are associated with lower rates of depression in non-pregnant adult populations, and interoception is generally weaker in …

Affect Regulation And Allostatic Load Over Time, Amanda E. Ng, Tara Gruenewald, Robert-Paul Juster, Claudia Trudel-Fitzgerald

Psychology Faculty Articles and Research

Objective

Emerging work suggests that affect regulation strategies (e.g., active coping, anger expression) predict disease and mortality risk, with sometimes divergent estimates by sex or education levels. However, few studies have examined potential underlying biological mechanisms. This study assessed the longitudinal association of affect regulation with future allostatic load.

Method

In 2004–2006, 574 participants from the Midlife in the United States study completed validated scales assessing use of nine general and emotion-specific regulatory strategies (e.g., denial, anger expression). As a proxy for how flexibly participants regulate their affect, variability in the use of regulatory strategies was operationalized using a standard …

The Role Of Positive Affect In Asthma Control And Symptom Severity In Adolescents, Brooke N. Jenkins, Logan T. Martin, Jill S. Halterman, Judith T. Moskowitz, Laura M. Glynn, Pornchai Tirakitsoontorn, Sunil Kamath, Zeev N. Kain

Psychology Faculty Articles and Research

Introduction

We test the effects of positive affect and its arousal subscale components of calm, wellbeing, and vigor on asthma control and symptom severity in adolescents with moderate to severe asthma. Additionally, we test whether positive affect (and its arousal components) moderate how stress impacts asthma control and symptom severity.

Methods

Adolescents with asthma (N = 66, ages 12–17) completed brief surveys 4 times a day for 7 days reporting on their positive affect, stress, and asthma symptom severity and conducted a morning peak expiratory flow assessment each day. Asthma control and psychological asthma triggers were assessed at the …

Mean Affect Moderates The Association Between Affect Variability And Mental Health, Brooke N. Jenkins, Lydia Q. Ong, Anthony D. Ong, Hee Youn (Helen) Lee, Julia K. Boehm

Psychology Faculty Articles and Research

Increasing evidence suggests that within-person variation in affect is a dimension distinct from mean levels along which individuals can be characterized. This study investigated affect variability’s association with concurrent and longitudinal mental health and how mean affect levels moderate these associations. The mental health outcomes of depression, panic disorder, self-rated mental health, and mental health professional visits from the second and third waves of the Midlife in the United States Study were used for cross-sectional (n = 1,676) and longitudinal outcomes (n = 1,271), respectively. These participants took part in the National Study of Daily Experiences (NSDE II), …

Individual Longitudinal Changes In Dna-Methylome Identify Signatures Of Early-Life Adversity And Correlate With Later Outcome, Annabel K. Short, Ryan Weber, Noriko Kamei, Christina Wilcox Thai, Hina Arora, Ali Mortazavi, Hal S. Stern, Laura M. Glynn, Tallie Z. Baram

Psychology Faculty Articles and Research

Adverse early-life experiences (ELA) affect a majority of the world's children. Whereas the enduring impact of ELA on cognitive and emotional health is established, there are no tools to predict vulnerability to ELA consequences in an individual child. Epigenetic markers including peripheral-cell DNA-methylation profiles may encode ELA and provide predictive outcome markers, yet the interindividual variance of the human genome and rapid changes in DNA methylation in childhood pose significant challenges. Hoping to mitigate these challenges we examined the relation of several ELA dimensions to DNA methylation changes and outcome using a within-subject longitudinal design and a high methylation-change threshold. …

Affect Variability And Cortisol In Context: The Moderating Roles Of Mean Affect And Stress, Brooke N. Jenkins, Logan T. Martin, Hee Youn (Helen) Lee, John F. Hunter, Amanda M. Acevedo, Sarah D. Pressman

Psychology Faculty Articles and Research

Positive and negative affect have been shown to have implications for hormones like cortisol but how moment to moment changes in affect (i.e., affect variability) influence cortisol secretion is less well understood. Additionally, context characteristics such as mean affect and stress may influence the association between affect variability and cortisol output. In the current study, we examined affect, stress, and cortisol data from 113 participants (age range = 25–63, M = 35.63, SD = 11.34; 29 % male; 42 % White/Caucasian, 37 % Asian or Pacific Islander, 13 % Hispanic/Latino, 4 % Black/African American, 1 % Native American, Eskimo, or …

Dhea: A Neglected Biological Signal That May Affect Fetal And Child Development, Natasha A. Bailey, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

The stress-sensitive maternal hypothalamic–pituitary–adrenal (HPA) axis through the end-product cortisol, represents a primary pathway through which maternal experience shapes fetal development with long-term consequences for child neurodevelopment. However, there is another HPA axis end-product that has been widely ignored in the study of human pregnancy. The synthesis and release of dehydroepiandosterone (DHEA) is similar to cortisol, so it is a plausible, but neglected, biological signal that may influence fetal neurodevelopment. DHEA also may interact with cortisol to determine developmental outcomes. Surprisingly, there is virtually nothing known about human fetal exposure to prenatal maternal DHEA and offspring neurodevelopment. The current study …

General Cognitive Ability In High School, Attained Education, Occupational Complexity, And Dementia Risk, Jimi Huh, Thalida Em Arpawong, Tara L. Gruenewald, Gwenith G. Fisher, Carol A. Prescott, Jennifer J. Manly, Dominika Seblova, Ellen E. Walters, Margaret Gatz

Psychology Faculty Articles and Research

INTRODUCTION

We address the extent to which adolescent cognition predicts dementia risk in later life, mediated by educational attainment and occupational complexity.

METHODS

Using data from Project Talent Aging Study (PTAS), we fitted two structural equation models to test whether adolescent cognition predicts cognitive impairment (CI) and Ascertain Dementia 8 (AD8) status simultaneously (N_{Cognitive Assessment} = 2477) and AD8 alone (N_{Questionnaire} = 6491) 60 years later, mediated by education and occupational complexity. Co-twin control analysis examined 82 discordant pairs for CI/AD8.

RESULTS

Education partially mediated the effect of adolescent cognition on CI in the cognitive assessment aample and …

Annual Research Review: The Power Of Predictability – Patterns Of Signals In Early Life Shape Neurodevelopment And Mental Health Trajectories, Elysia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

The global burden of early life adversity (ELA) is profound. The World Health Organization has estimated that ELA accounts for almost 30% of all psychiatric cases. Yet, our ability to identify which individuals exposed to ELA will develop mental illness remains poor and there is a critical need to identify underlying pathways and mechanisms. This review proposes unpredictability as an understudied aspect of ELA that is tractable and presents a conceptual model that includes biologically plausible mechanistic pathways by which unpredictability impacts the developing brain. The model is supported by a synthesis of published and new data illustrating the significant …

Infant Hedonic/Anhedonic Processing Index (Hapi-Infant): Assessing Infant Anhedonia And Its Prospective Association With Adolescent Depressive Symptoms, Jessica L. Irwin, Elysia Poggi Davis, Curt A. Sandman, Tallie Z. Baram, Hal S. Stern, Laura M. Glynn

Psychology Faculty Articles and Research

Background

Anhedonia, an impairment in the motivation for or experience of pleasure, is a well-established transdiagnostic harbinger and core symptom of mental illness. Given increasing recognition of early life origins of mental illness, we posit that anhedonia should, and could, be recognized earlier if appropriate tools were available. However, reliable diagnostic instruments prior to childhood do not currently exist.

Methods

We developed an assessment instrument for anhedonia/reward processing in infancy, the Infant Hedonic/Anhedonic Processing Index (HAPI-Infant). Exploratory factor and psychometric analyses were conducted using data from 6- and 12-month-old infants from two cohorts (N = 188, N = 212). …

Childhood Unpredictability Is Associated With Increased Risk For Long- And Short-Term Depression And Anhedonia Symptoms Following Combat Deployment, Christopher Hunt, Meghan Vinograd, Laura M. Glynn, Elysia Poggi Davis, Tallie Z. Baram, Hal S. Stern, Caroline M. Nievergelt, Bruna Cuccurazzu, Cindy Napan, Dylan Delmar, Dewleen G. Baker, Victoria B. Risbrough

Psychology Faculty Articles and Research

High unpredictability has emerged as a dimension of early-life adversity that may contribute to a host of deleterious consequences later in life. Early-life unpredictability affects development of limbic and reward circuits in both rodents and humans, with a potential to increase sensitivity to stressors and mood symptoms later in life. Here, we examined the extent to which unpredictability during childhood was associated with changes in mood symptoms (anhedonia and general depression) after two adult life stressors, combat deployment and civilian reintegration, which were assessed ten years apart. We also examined how perceived stress and social support mediated and /or moderated …

One Size Doesn’T Fit All: Attitudes Towards Work Modify The Relation Between Parental Leave Length And Postpartum Depression, Christine Y. Chang, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

The present study aimed to investigate the relationship between parental leave length and maternal depressive symptoms at six- and twelve-months postpartum and whether this relation was influenced by women’s attitudes towards leave, whether leave was paid or unpaid, and the reason they returned to work. The sample included 115 working women recruited during pregnancy as part of a larger longitudinal study. Analyses revealed that maternal attitudes toward leave influenced the association between leave length and depressive symptoms. Specifically, longer leaves were associated with increased depressive symptoms for women who missed their previous activities at work. Furthermore, women who missed work …

Theories Of Consciousness And A Life Worth Living, Liad Mudrik, Myrto Mylopoulos, Niccolo Negro, Aaron Schurger

Psychology Faculty Articles and Research

What is it that makes a life valuable? A popular view is that life’s moral worth depends in some way on its relationship to consciousness or subjective experience. But a practical application of this view requires the ability to test for consciousness, which is currently lacking. Here, we examine how theories of consciousness (ToCs) can help do so, focusing especially on difficult cases where the answer is not clear (e.g. fetuses, nonhuman animals, unresponsive brain-injured patients, and advanced artificial systems). We consider five major ToCs and what predictions they offer: Integrated information theory, Higher-Order Thought Theory, Recurrent Processing Theory, Global …

Affect Variability And Physical Health: The Moderating Role Of Mean Affect, Brooke N. Jenkins, Lydia Q. Ong, Hee Youn (Helen) Lee, Anthony D. Ong, Julia K. Boehm

Psychology Faculty Articles and Research

Research has only begun to explore how affect variability relates to physical health and has typically not assessed long-term associations nor considered the moderating role of mean affect. Therefore, we used data from the Midlife in the United States Study waves 2 (N = 1512) and 3 (N = 1499) to test how affect variability predicted concurrent and long-term physical health while also testing the moderating role of mean affect. Results indicated that greater negative affect variability was associated concurrently with a greater number of chronic conditions (p = .03) and longitudinally with worse self-rated physical health (p …

Time Of Day Preferences And Daily Temporal Consistency For Predicting The Sustained Use Of A Commercial Meditation App: Longitudinal Observational Study, Vincent Berardi, Ryan Fowers, Gavriella Rubin, Chad Stecher

Psychology Faculty Articles and Research

Background: The intensive data typically collected by mobile health (mHealth) apps allows factors associated with persistent use to be investigated, which is an important objective given users’ well-known struggles with sustaining healthy behavior.

Objective: Data from a commercial meditation app (n=14,879; 899,071 total app uses) were analyzed to assess the validity of commonly given habit formation advice to meditate at the same time every day, preferably in the morning.

Methods: First, the change in probability of meditating in 4 nonoverlapping time windows (morning, midday, evening, and late night) on a given day over the first 180 days …

Experiences Of Covid-19-Related Racism And Impact On Depression Trajectories Among Racially/Ethnically Minoritized Adolescents, Sabrina R. Liu, Elysia Poggi Davis, Anton M. Palma, Hal S. Stern, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Purpose

In 2020, racially/ethnically minoritized (REMD) youth faced the “dual pandemics” of COVID-19 and racism, both significant stressors with potential for adverse mental health effects. The current study tested whether short- and long-term trajectories of depressive symptoms from before to during the COVID-19 pandemic differed between REMD adolescents who did and did not endorse exposure to COVID-19-era-related racism (i.e., racism stemming from conditions created or exacerbated by the COVID-19 pandemic).

Methods

A community sample of 100 REMD adolescents enrolled in an ongoing longitudinal study of mental health was assessed before and during the COVID-19 pandemic. Participants were 51% girls, mean …

Adolescent Psychological Assets And Cardiometabolic Health Maintenance In Adulthood: Implications For Health Equity, Farah Qureshi, Anne‐Josee Guimond, Elaine Tsao, Scott Delaney, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

Background

Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals—particularly members of minoritized racial and ethnic groups—meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity.

Methods and Results

Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994–1995; mean age=16 years), data on 5 psychological assets (optimism, …

Early Life Exposure To Unpredictable Parental Sensory Signals Shapes Cognitive Development Across Three Species, Elyssia Poggi Davis, Kari Mccormack, Hina Arora, Desiree Sharpe, Annabel K. Short, Jocelyne Bachevalier, Laura M. Glynn, Curt A. Sandman, Hal S. Stern, Mar Sanchez, Tallie Z. Baram

Psychology Faculty Articles and Research

Exposure to early life adversity has long term consequences on cognitive function. Most research has focused on understanding components of early life adversities that contribute to later risk, including poverty, trauma, maltreatment, and neglect. Whereas these factors, in the aggregate, explain a significant proportion of emotional and cognitive problems, there are serious gaps in our ability to identify potential mechanisms by which early life adversities might promote vulnerability or resilience. Here we discuss early life exposure to unpredictable signals from the caretaker as an understudied type of adversity that is amenable to prevention and intervention. We employ a translational approach …

The Social Determinants Of Ideal Cardiovascular Health: A Global Systematic Review, Farah Qureshi, Kelb Bousquet-Santos, Sakurako S. Okuzono, Elaine Tsao, Scott Delaney, Anne-Josie Guimond, Julia K. Boehm, Laura D. Kubzansky

Psychology Faculty Articles and Research

This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = …

Macrodosing To Microdosing With Psychedelics: Clinical, Social, And Cultural Perspectives, Ayse Ceren Kaypak, Amir Raz

Psychology Faculty Articles and Research

To date, the clinical and scientific literature has best documented the effects of classical psychedelics, such as lysergic acid diethylamide (LSD), psilocybin, and dimethyltryptamine (DMT), in typical quantities most often associated with macrodosing. More recently, however, microdosing with psychedelics has emerged as a social trend and nascent therapeutic intervention. This variation in psychedelic practice refers to repeat, intermittent ingestion of less-than-macrodose amounts that do not cause the effects associated with full-blown “trips”. Microdosing paves the road to incorporating psychedelic drugs into a daily routine while maintaining, or even improving, cognitive and mental function. Unlike macrodosing with psychedelics, the influence of …

Contribution Of Early-Life Unpredictability To Neuropsychiatric Symptom Patterns In Adulthood, Andrea D. Spadoni, Meghan Vinograd, Bruna Cuccurazzu, Katy Torres, Laura M. Glynn, Elysia P. Davis, Tallie Z. Baram, Dewleen G. Baker, Caroline M. Nievergelt, Victoria B. Risbrough

Psychology Faculty Articles and Research

Background

Recent studies in both human and experimental animals have identified fragmented and unpredictable parental and environmental signals as a novel source of early-life adversity. Early-life unpredictability may be a fundamental developmental factor that impacts brain development, including reward and emotional memory circuits, affecting the risk for psychopathology later in life. Here, we tested the hypothesis that self-reported early-life unpredictability is associated with psychiatric symptoms in adult clinical populations.

Methods

Using the newly validated Questionnaire of Unpredictability in Childhood, we assessed early-life unpredictability in 156 trauma-exposed adults, of which 65% sought treatment for mood, anxiety, and/or posttraumatic stress disorder (PTSD) …

Psychological Well-Being In Childhood And Cardiometabolic Risk In Middle Adulthood: Findings From The 1958 British Birth Cohort, Julia K. Boehm, Farah Qureshi, Laura D. Kubzansky

Psychology Faculty Articles and Research

Childhood adversity is linked to poor cardiometabolic outcomes, but less is known about positive childhood factors. Using data from 4,007 members of the 1958 British Birth Cohort, we investigated whether children with greater psychological well-being had lower adulthood cardiometabolic risk. At age 11, participants wrote essays about their future. Two judges rated each essay for nine psychological well-being items (Finn’s r = .82–.91), which were combined into a standardized overall score (Cronbach’s α = .91). When participants reached age 45, nurses assessed their blood pressure, heart rate, lipids, glycosylated hemoglobin, fibrinogen, and C-reactive protein, which were standardized and summed for …

Stability And Flexibility In Psychotherapy Process Predict Outcome, Giulio De Felice, Alessandro Giuliani, David Pincus, Andrea Scozzari, Vincent Berardi, Leonhard Kratzer, Wolfgang Aichhorn, Helmut J. Schöller, Kathrin Viol, Günter Schiepek

Psychology Faculty Articles and Research

Ten good outcome and ten poor outcome psychotherapy cases were compared to investigate whether or not the temporal stability and flexibility of their process variables can predict their outcomes. Each participant was monitored daily using the Therapy Process Questionnaire (TPQ), which has 43 items and seven sub-scales, and responses over time were analyzed in terms of correlation robustness and correlation variability across the TPQ sub-scales. “Correlation robustness” and “correlation variability” are two basic characteristics of any correlation matrix: the first is calculated as the sum of the absolute values of Pearson correlation coefficients, the second as the standard deviation of …

Free Will Without Consciousness?, Liad Mudrik, Inbal Gur Arie, Yoni Amir, Yarden Shir, Pamela Hieronymi, Uri Maoz, Timothy O'Connor, Aaron Schurger, Manuel Vargas, Tillman Vierkant, Walter Sinnott-Armstrong, Adina Roskies

Psychology Faculty Articles and Research

Findings demonstrating decision-related neural activity preceding volitional actions have dominated the discussion about how science can inform the free will debate. These discussions have largely ignored studies suggesting that decisions might be influenced or biased by various unconscious processes. If these effects are indeed real, do they render subjects’ decisions less free or even unfree? Here, we argue that, while unconscious influences on decision-making do not threaten the existence of free will in general, they provide important information about limitations on freedom in specific circumstances. We demonstrate that aspects of this long-lasting controversy are empirically testable and provide insight into …

Obesogenic Environments And Cardiovascular Disease: A Path Analysis Using Us Nationally Representative Data, Fangqi Guo, Georgiana Bostean, Vincent Berardi, Alfredo J. Velasquez, Jennifer W. Robinette

Psychology Faculty Articles and Research

Introduction

People living in obesogenic environments, with limited access to healthful food outlets and exercise facilities, generally have poor health. Previous research suggests that behavioral risk factors and indicators of physiological functioning may mediate this link; however, no studies to date have had the requisite data to investigate multi-level behavioral and physiological risk factors simultaneously. The present study conducted serial and parallel mediation analyses to examine behavioral and physiological pathways explaining the association between environmental obesogenicity and cardiovascular disease (CVD).

Methods

This cross-sectional observational study used data from the 2012–2016 Health and Retirement Study, a representative survey of US older …

Intergenerational Risk And Resilience Pathways From Discrimination And Acculturative Stress To Infant Mental Health, Sabrina R. Liu, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers’ exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related …

The Rubber Hand Illusion: Top-Down Attention Modulates Embodiment, Rémi Thériault, Mathieu Landry, Amir Raz

Psychology Faculty Articles and Research

The Rubber Hand Illusion (RHI) creates distortions of body ownership through multimodal integration of somatosensory and visual inputs. This illusion largely rests on bottom-up (automatic multisensory and perceptual integration) mechanisms. However, the relative contribution from top-down factors, such as controlled processes involving attentional regulation, remains unclear. Following previous work that highlights the putative influence of higher-order cognition in the RHI, we aimed to further examine how modulations of working memory load and task instructions—two conditions engaging top-down cognitive processes—influence the experience of the RHI, as indexed by a number of psychometric dimensions. Relying on exploratory factor analysis for assessing this …

Consciousness Explained Or Described?, Aaron Schurger, Michael S. A. Graziano

Psychology Faculty Articles and Research

Consciousness is an unusual phenomenon to study scientifically. It is defined as a subjective, first-person phenomenon, and science is an objective, third-person endeavor. This misalignment between the means—science—and the end—explaining consciousness—gave rise to what has become a productive workaround: the search for ‘neural correlates of consciousness’ (NCCs). Science can sidestep trying to explain consciousness and instead focus on characterizing the kind(s) of neural activity that are reliably correlated with consciousness. However, while we have learned a lot about consciousness in the bargain, the NCC approach was not originally intended as the foundation for a true explanation of consciousness. Indeed, it …

Optimism And Lipid Profiles In Midlife: A 15-Year Study Of Black And White Adults, Farah Qureshi, Jackie Soo, Ying Chen, Brita Roy, Donald Lloyd-Jones, Laura D. Kubzansky, Julia K. Boehm

Psychology Faculty Articles and Research

Introduction

Optimism is associated with better cardiovascular health, yet little is known about the underlying mechanisms and whether protective relationships are consistently observed across diverse groups. This study examines optimism's association with lipid profiles over time and separately among Black and White men and women.

Methods

Data were from 3,206 middle-aged adults in the Coronary Artery Risk Development in Young Adults study. Optimism was measured in 2000–2001 using the Revised Life Orientation Test. Triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol measurements were obtained at 5-year intervals through 2015–2016. Linear mixed models evaluated relationships between optimism and …

Is More, Better? Relationships Of Multiple Psychological Well-Being Facets With Cardiometabolic Disease, Anna-Josée Guimond, Claudia Trudel-Fitzgerald, Julia K. Boehm, Farah Qureshi, Laura D. Kubzansky

Psychology Faculty Articles and Research

Objective: Cardiometabolic disease (CMD) is a leading cause of death and disability worldwide. Assessments of psychological well-being taken at one time point are linked to reduced cardiometabolic risk, but psychological well-being may change over time and how longitudinal trajectories of psychological well-being may be related to CMD risk remains unclear. Furthermore, psychological well-being is a multidimensional construct comprised of distinct facets, but no work has examined whether sustaining high levels of multiple facets may confer additive protection. This study tested if trajectories of four psychological well-being facets would be associated with lower risk of self-reported nonfatal CMD. Method: Participants were …