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Amy E. Richardson and Elizabeth Broadbent
Cognitions about illness have been identified as contributors to health-related behavior, psychological well-being, and overall health. Several different theories have been developed to explain how cognitions may exert their impact on health outcomes. This article includes three theories: the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the Common Sense Model (CSM), with the primary focus on the CSM. The HBM posits that cognitions regarding susceptibility to a health threat, the severity of the threat, and the benefits and costs associated with behavior, will determine whether or not a behavior is performed. In the TPB, behavior is thought to be a consequence of intention to act, which is shaped by attitudes regarding a behavior, subjective norms, and perceived behavioral control. The Common Sense Model (CSM) proposes that individuals form cognitive representations of illness (known as illness perceptions) as well as emotional representations, which are key determinants of coping behaviors to manage the illness. Coping behaviors are theorized to have direct relationships with physical and psychological health outcomes. Cognitive representations encompass perceptions regarding the consequences posed by the illness, its timeline, personal ability to control the illness, whether the illness can be cured or controlled by treatment, and the identity of the illness (including its label and symptoms). Emotional representations reflect feelings such as fear, anger, and depression about the illness. The development of illness representations is influenced by a number of factors, including personal experience, the nature of physical symptoms, personality traits, and the social and cultural context. Illness cognitions can vary considerably between patients and health care professionals. There are a number of methods to assess illness-related cognitions, and increasing evidence that modifying negative or inaccurate cognitions can improve health outcomes.
Victoria M. Esses
Migration is the movement of people from one location to another, either within a country (internal migration between cities or regions) or between countries (international migration). Migration may be relatively voluntary (e.g., for employment opportunities) or involuntary (e.g., due to armed conflict, persecution, or natural disasters), and it may be temporary (e.g., migrant workers moving back and forth between source and receiving areas) or permanent (e.g., becoming a permanent resident in a new country). The term immigration refers specifically to international migration that is relatively permanent in nature. Immigrants are those individuals who have moved to a new country on a relatively permanent basis. Of importance, refugees are a particular type of immigrant, defined and protected by international law. They are individuals who have been formally recognized as having fled their country of residence because of a well-founded fear of persecution, armed conflict, violence, or war. Until they are recognized as such, these individuals are asylum seekers—individuals who have claimed refugee status and are waiting for that claim to be evaluated. Despite the relative permanence of immigration, advances in transportation and communication mean that immigrants are able to travel to, spend time in, and communicate on a regular basis with their country of origin. As a result, what has been termed transnationalism may result, with individuals holding strong ties with, and actively participating in, both the country of origin and the new receiving country.
Migration often results in two or more cultures coming into contact. This contact is especially likely for international migration where immigrants from one national group (the society of origin) come into contact with members of a different national group (the receiving society). Culture may include specific beliefs, attitudes, and customs, as well as values and behaviors. The term acculturation refers to the changes that may occur when individuals from different cultures come into contact, with possible changes in both immigrants and members of the receiving society. Psychological theory and research suggest that acculturation is bidimensional, with changes potentially taking place along two dimensions—one representing the maintenance or loss of the original culture and the other representing the adoption or rejection of the new culture. This bidimensionality is important because it suggests that acculturation is not linear from original culture to new culture, but instead that individuals may simultaneously participate in the new culture and maintain their original culture. The two cultures may be expressed at different times, in different contexts, or may merge to form cultural expressions that have aspects of both cultures. With voluntary and involuntary migration at historically high levels, understanding the drivers of migration and its consequences for migrants and those with whom they come into contact are essential for global cooperation and well-being.
Emma V. Ward and David R. Shanks
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Psychology. Please check back later for the full article.
It is well documented that explicit (declarative, conscious) memory declines in normal aging. Studies have shown a progressive reduction in this form of memory with age, and healthy older adults (typically aged 65+ years) usually perform worse than younger adults (typically aged 18–30 years) on laboratory tests of explicit memory such as recall and recognition. In contrast, it is less clear whether implicit (procedural, unconscious) memory declines or remains stable in normal aging. Implicit memory is evident when previous experiences affect (e.g., facilitate) performance on tasks that do not require conscious recollection of those experiences. This can manifest in rehearsed motor skills, such as playing a musical instrument, but is typically indexed in the laboratory by the greater ease with which previously studied information is processed relative to non-studied information (e.g., repetition-priming). While a vast amount of research has accumulated to suggest that implicit memory remains relatively stable over the adult life span and is similar in samples of young and older adults, other studies have, in contrast, revealed that implicit memory is subject to age-related decline. Improving methods for determining whether implicit memory declines or remains stable with age is an important goal for future research, as the conclusion not only holds fundamental implications for an aging society, but can also inform our theoretical understating of human memory systems.
Stephanie J. Wilson, Alex Woody, and Janice K. Kiecolt-Glaser
Inflammatory markers provide invaluable tools for studying health and disease across the lifespan. Inflammation is central to the immune system’s response to infection and wounding; it also can increase in response to psychosocial stress. In addition, depression and physical symptoms such as pain and poor sleep can promote inflammation and, because these factors fuel each other, all contribute synergistically to rising inflammation. With increasing age, persistent exposure to pathogens and stress can induce a chronic proinflammatory state, a process known as inflamm-aging.
Inflammation’s relevance spans the life course, from childhood to adulthood to death. Infection-related inflammation and stress in childhood, and even maternal stress during pregnancy, may presage heightened inflammation and poor health in adulthood. In turn, chronically heightened inflammation in adulthood can foreshadow frailty, functional decline, and the onset of inflammatory diseases in older age.
The most commonly measured inflammatory markers include C-reactive protein (CRP) and proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These biomarkers are typically measured in serum or plasma through blood draw, which capture current circulating levels of inflammation. Dried blood spots offer a newer, sometimes less expensive collection method but can capture only a limited subset of markers. Due to its notable confounds, salivary sampling cannot be recommended.
Inflammatory markers can be added to a wide range of lifespan developmental designs. Incorporating even a single inflammatory assessment to an existing longitudinal study can allow researchers to examine how developmental profiles and inflammatory status are linked, but repeated assessments must be used to draw conclusions about the associations’ temporal order and developmental changes. Although the various inflammatory indices can fluctuate from day to day, ecological momentary assessment and longitudinal burst studies have not yet incorporated daily inflammation measurement; this represents a promising avenue for future research.
In conclusion, mounting evidence suggests that inflammation affects health and disease across the lifespan and can help to capture how stress “gets under the skin.” Incorporating inflammatory biomarkers into developmental studies stands to enhance our understanding of both inflammation and lifespan development.
DeMond M. Grant and Evan J. White
Cognitive control is the ability to direct attention and cognitive resources toward achieving one’s goals. However, research indicates that anxiety biases multiple cognitive processes, including cognitive control. This occurs in part because anxiety leads to excessive processing of threatening stimuli at the expense of ongoing activities. This enhanced processing of threat interferes with several cognitive processes, which includes how individuals view and respond to their environment. Specifically, research indicates that anxious individuals devote their attention toward threat when considering both early, automatic processes and later, sustained attention. In addition, anxiety has negative effects on working memory, which involves the ability to hold and manipulate information in one’s consciousness. Anxiety has been found to decrease the resources necessary for effective working memory performance, as well as increase the likelihood of negative information entering working memory. Finally, anxiety is characterized by focusing excessive attention on mistakes, and there is also a reduction in the cognitive control resources necessary to correct behavior. Enhancing our knowledge of how anxiety affects cognitive control has broad implications for understanding the development of anxiety disorders, as well as emerging treatments for these conditions.
This article aims to provide a narrative overview on injury prevention in sport and performance psychology. Research and applied interest in psychological injury prevention in sport and performance psychology has risen in popularity over the past few decades. To date, existing theoretical models, pure and applied research, and practice-based evidence has focused on conceptualizing and examining psychological injury occurrence and prevention through stress-injury mechanisms, and predominantly in sport injury settings. However, given the inherited similarities across the different performance domains however, it is the authors’ belief that existing injury prevention knowledge can be transferable beyond sport but should be done with caution. A range of cognitive-affective-behavioral strategies such as goal setting, imagery, relaxation strategies, self-talk, and social support have been found beneficial in reducing injuries, particularly when used systematically (a) prior to injury occurrence as part of performance enhancement program and/or as a specific injury prevention measure, (b) during injury rehabilitation, and (c) as part of a return-to-activity process to minimize the risk of secondary injuries and reinjuries. Existing theoretical and empirical evidence also indicates that using cognitive-affective-behavioral strategies for injury prevention are effective when used as part of a wider, multi-modal intervention. Equally, such interventions may also need to address possible behavioral modifications required in sleep, rest, and recovery. Considering the existing empirical and anecdotal evidence to date, this paper argues that injury prevention efforts in sport and performance psychology should be cyclical, biopsychosocial, and person-centered in nature. In short, injury prevention should be underpinned by recognition of the interplay between personal (both physical and psychological), environmental, and contextual characteristics, and how they affect the persons’ cognitive-affective-behavioral processes before, during, and after injury occurrence, at different phases of rehabilitation, and during the return to activity or retirement from activity process. Moreover, these holistic injury prevention efforts should be underpinned by a philosophy that injury prevention is inherently intertwined with performance enhancement, with the focus being on the individual and their overall well-being.
Deborah M. Capaldi, David C. R. Kerr, and Stacey S. Tiberio
Intergenerational studies are key to informing research, preventive intervention, and policy regarding family influences on healthy development and maladjustment. Continuities in family socialization and contextual risks across generations, as well as genetic factors, are associated with the development of psychopathology—including externalizing problems in children—and with intergenerational associations in the use of marijuana, alcohol, tobacco, and other drugs; these continuities are reflected in the low-to-moderate associations generally found in prospective studies. Until recent years, estimates of intergenerational continuities in problem behaviors and the processes explaining such associations (e.g., parenting behaviors) have been based largely on retrospective reports by adults about their own parents’ behaviors. Now there are some long-term prospective studies spanning as many as 30 years that can assess linkages between behaviors in one generation and the next. Whereas such studies have considerable design and implementation challenges, and are very expensive, it is of critical importance to examine the magnitude of associations of behaviors across generations. For example, a modest association across generations suggests either that genetic factors have a limited influence on that behavior or that they are subject to considerable moderation by environmental factors. These prospective studies relate to theoretical developments regarding intergenerational influences that are reviewed—for example, individual differences in genetic sensitivity to environmental influences. The theoretical approach employed in the Oregon Youth Study—Three Generation Study is a Dynamic Developmental Systems (DDS) model of continuous feedback across systems throughout development. A new hypothesis encompassed by DDS is developmental congruence of intergenerational associations in problem behaviors. As used in geometry, congruence refers to figures of a similar shape and size. This term has been adapted to refer to the expectation that ages of onset and patterns of growth in key behaviors will show similarity across generations. This is based on the theory that genetic and temperamental factors increase an individual’s risk when these factors are expressed at sensitive developmental periods. Thus, the timing of these manifestations (e.g., susceptibility to deviant peer influences) is expected to be similar across generations. Developmental similarity is also likely due to continuities in social-risk context and family mechanisms, such as parenting.
Stuart Linke and Elizabeth Murray
Alcohol-use disorders are widespread and associated with a greatly increased risk of health-related and societal harms. The majority of harms associated with consumption are experienced by those who drink above recommended guidelines, rather than those who are alcohol dependent. Brief interventions and treatments based on screening questionnaires and feedback have been developed for this group, which are effective tools for reducing consumption in primary care and in other settings. Most people who drink excessively do not receive help to reduce the risks associated with excessive consumption. Digital versions of brief and extended interventions have the potential to reach populations that might derive benefit from them. Digital interventions utilize the same principles as do traditional face-to-face versions, but they have the advantages of availability, confidentiality, flexibility, low marginal costs, and treatment integrity. The evidence for the feasibility, acceptability, costs, and effectiveness of digital interventions is encouraging, and the evidence for effectiveness is particularly strong in studies of student populations. There are, however, a number of unresolved questions. It is not clear which components of interventions are required to maximize effectiveness, whether digital versions are enhanced by the addition of personal contact from a facilitator or a health professional, or how to increase take up of the offer of a digital intervention and reduce attrition from a program. These questions are common to many online behavior-change interventions and there are opportunities for cross-disciplinary learning between psychologists, health professionals, computer scientists, and e-health researchers.
Gregory A. Hinrichsen
In clinical practice with older adults, depression is a common presenting problem and is usually interwoven with one or more life problems. These problems are often the focus of psychotherapy. Interpersonal Psychotherapy (IPT) is a highly researched and effective treatment for depression in adults and older adults. IPT is time-limited, and as an individual psychotherapy it is usually conducted over 16 sessions. IPT focuses on one or two of four interpersonally relevant problems that may be a cause or consequence of depression. These include: role transitions (life change), interpersonal role disputes (conflict with another person), grief (complicated bereavement), and interpersonal deficits (social isolation and loneliness). The four IPT problem areas reflect issues that are frequently seen in psychotherapy with depressed older people.
Anja Van den Broeck and Sharon K. Parker
Job design or work design refers to the content, structure, and organization of tasks and activities. It is mostly studied in terms of job characteristics, such as autonomy, workload, role problems, and feedback. Throughout history, job design has moved away from a sole focus on efficiency and productivity to more motivational job designs, including the social approach toward work, Herzberg’s two-factor model, Hackman and Oldham’s job characteristics model, the job demand control model of Karasek, Warr’s vitamin model, and the job demands resources model of Bakker and Demerouti. The models make it clear that a variety of job characteristics make up the quality of job design that benefits employees and employers alike. Job design is crucial for a whole range of outcomes, including (a) employee health and well-being, (b) attitudes like job satisfaction and commitment, (c) employee cognitions and learning, and (d) behaviors like productivity, absenteeism, proactivity, and innovation. Employee personal characteristics play an important role in job design. They influence how employees themselves perceive and seek out particular job characteristics, help in understanding how job design exerts its influence, and have the potential to change the impact of job design.
Vincente Martínez-Tur and Carolina Moliner
Traditionally, justice in teams refers to a specific climate—called justice climate—describing shared perceptions about how the team as a whole is treated. Justice at the individual level has been a successful model from which to build the concept of justice in teams. Accordingly, there is a parallelism between the individual and team levels in the investigation of justice, where scholars’ concerns and responses have been very similar, despite studying different levels of construct. However, the specific particularities of teams are increasingly considered in research. There are three concepts (faultlines, subgrouping, and intergroup justice) that contribute to knowledge by focusing on particularities of teams that are not present at the individual level. The shift toward team-based structures provides an opportunity to observe the existence of dividing lines that may split a team into subgroups (faultlines) and the difficulty, in many cases, of conceiving of the team members as part of a single group. This perspective about teams also stimulates the study of the subgroup as a source of justice and the focus on intergroup justice within the team. In sum, the organizational context facilitates shared experiences and perceptions of justice beyond individual differences but also can result in potential conflicts and discrepancies among subgroups within the team in their interpretation of fairness.
Erica H. Wojcik, Irene de la Cruz-Pavía, and Janet F. Werker
Language is a structured form of communication that is unique to humans. Within the first few years of life, typically developing children can understand and produce full sentences in their native language or languages. For centuries, philosophers, psychologists, and linguists have debated how we acquire language with such ease and speed. Central to this debate has been whether the learning process is driven by innate capacities or information in the environment. In the field of psychology, researchers have moved beyond this dichotomy to examine how perceptual and cognitive biases may guide input-driven learning and how these biases may change with experience. There is evidence that this integration permeates the learning and development of all aspects of language—from sounds (phonology), to the meanings of words (lexical-semantics), to the forms of words and the structure of sentences (morphosyntax). For example, in the area of phonology, newborns’ bias to attend to speech over other signals facilitates early learning of the prosodic and phonemic properties of their native language(s). In the area of lexical-semantics, infants’ bias to attend to novelty aids in mapping new words to their referents. In morphosyntax, infants’ sensitivity to vowels, repetition, and phrase edges guides statistical learning. In each of these areas, too, new biases come into play throughout development, as infants gain more knowledge about their native language(s).
W. James Weese and P. Chelladurai
The study of leadership has a long and distinguished history. Over the past 100 years, researchers have pursued distinct lines of inquiry summarized in the trait theories, the behavioral theories, the contingency theories, and the transactional/transformational theories of leadership. More recent cognitive approaches have dominated the leadership literature base with emphasis on the areas of emotional intelligence and servant leadership. Even as new leadership models emerge, it is important to note that portions of the older theories continue to inform our understandings. The voluminous research base confirms three things about leadership. Leadership is a social process, involving people and engaging their emotions, motivations, and moods. Secondly, leadership is about influence. True leaders influence the thoughts and behaviors of people and groups without the manipulation of rewards or punishments. Some writers suggest that leadership is synonymous with influence. Finally, leaders focus, inspire, and motivate people and groups toward the accomplishment of a predetermined goal or objective. They bring clarity to a desired end and they inspire colleagues to channel their talents and energies toward its attainment. The theoretical developments of leadership, and the latest developments in particular (i.e., emotional intelligence and servant leadership), hold great promise for application in the sports domain.
Markus Wettstein, Hans-Werner Wahl, and Michael Schwenk
When referring to life space, researchers usually mean the area in which individuals move in their everyday lives. Life space can be measured based on different approaches, by means of self-reports (i.e., questionnaires or diaries) or by more recent approaches of technology-based objective assessment (e.g., via Global Positioning System [GPS] devices or smartphones). Life space is an important indicator of older adults’ out-of-home mobility and is meaningfully associated with autonomy, well-being, and quality of life. Substantial relationships between life space and socio-demographic indicators, health, and cognitive abilities have been reported in previous research. Future research on life space in old age will benefit from a more comprehensive and stronger interdisciplinary perspective, from taking into account different time scales (i.e., short- and long-term variability), and from considering life space as a multidimensional measure that can be best assessed based on multi-method approaches with multiple indicators.
Loneliness or perceived social isolation is a subjective experience relating to dissatisfaction with one’s social relationships. Most research has focused on the experience of loneliness in old age, but levels of loneliness are also known to be high among teenagers and young adults. While poor health may be associated with increased feelings of loneliness, there is now considerable evidence on the role of loneliness as a risk factor for poor mental and physical health. Studies show that loneliness is associated with an increased risk of developing dementia and chronic diseases, and also with a higher rate of mortality. Risky health behaviors, a poor cardiovascular profile and compromised immune functioning have all been proposed as potential pathways through which loneliness may affect health. However, much still remains to be understood about these mechanisms.
Matthew S. Fritz and Houston F. Lester
Mediator variables are variables that lie between the cause and effect in a causal chain. In other words, mediator variables are the mechanisms through which change in one variable causes change in a subsequent variable. The single-mediator model is deceptively simple because it has only three variables: an antecedent, a mediator, and a consequent. Determining that a variable functions as a mediator is a difficult process, however, because causation can be inferred only when many strict assumptions are met, including, but not limited to, perfectly reliable measures, correct temporal design, and no omitted confounders. Since many of these assumptions are difficult to assess and rarely met in practice, the significance of a statistical test of mediation alone usually provides only weak evidence of mediation.
New methodological approaches are constantly being developed to circumvent these limitations. Specifically, new methods are being created for the following purposes: (1) to assess the impact of violating assumptions (e.g., sensitivity analyses) and (2) to make fewer assumptions and provide more flexible analysis techniques (e.g., Bayesian analysis or bootstrapping) that may be more robust to assumption violations. Despite these advances, the importance of the design of a study cannot be overstated. A statistical analysis, no matter how sophisticated, cannot redeem a study that measured the wrong variables or used an incorrect temporal design.
Nicole D. Anderson
Healthy aging is accompanied by decrements in episodic memory and working memory. Significant efforts have therefore been made to augment episodic and working memory in healthy older adults. Two principal approaches toward memory rehabilitation adults are restorative approaches and compensatory approaches. Restorative approaches aim to repair the affected memory processes by repeated, adaptive practice (i.e., the trained task becomes more difficult as participants improve), and have focused on recollection training, associative memory training, object-location memory training, and working memory training. The majority of these restorative approaches have been proved to be efficacious, that is, participants improve on the trained task, and there is considerable evidence for maintenance of training effects weeks or months after the intervention is discontinued. Transfer of restorative training approaches has been more elusive and appears limited to other tasks relying on the same domains or processes. Compensatory approaches to memory strive to bypass the impairment by teaching people mnemonic and lifestyle strategies to bolster memory performance. Specific mnemonic strategy training approaches as well as multimodal compensatory approaches that combine strategy training with counseling about other factors that affect memory (e.g., memory self-efficacy, relaxation, exercise, and cognitive and social engagement) have demonstrated that older adults can learn new mnemonics and implement them to the benefit of memory performance, and can adjust their views and expectations about their memory to better cope with the changes that occur during healthy aging. Future work should focus on identifying the personal characteristics that predict who will benefit from training and on developing objective measures of the impact of memory rehabilitation on older adults’ everyday functioning.
Christopher Hertzog and Taylor Curley
Metamemory is defined as cognitions about memory and related processes. Related terms in the literature include metacognition, self-evaluation, memory self-efficacy, executive function, self-regulation, cognitive control, and strategic behavior. Metamemory is a multidimensional construct that includes knowledge about how memory works, beliefs about memory (including beliefs about one’s own memory such as memory self-efficacy), monitoring of memory and related processes and products, and metacognitive control, in which adaptive changes in processing approaches and strategies may be contemplated if monitoring of memory processes (encoding, retention, retrieval) indicates that alternative strategies may be required. Older adults generally believe that their memory has declined and that, on average, they have less control over memory and lower memory self-efficacy than young and middle-aged adults. Many but not all aspects of online memory monitoring are well preserved in old age, such as the ability to discriminate between information that has been learned versus not learned. A major exception concerns confidence judgments concerning whether recognition memory decisions are correct; older adults are more prone to high-confidence memory errors, believing they are recognizing something they have not encountered previously. The evidence regarding metacognitive control is more mixed, with some hints that older adults do not use monitoring to adjust control behaviors (e.g., devoting more time and effort to studying items they believe have not yet been well-learned). However, any age deficits in self-regulation based on memory monitoring or adaptive strategy use can probably be addressed through instructions, practice, or training. In general, older adults seem capable of exerting metacognitive control in memory studies, although they may not necessarily do so without explicit support or prompting.
Ildiko Tombor and Susan Michie
People’s behavior influences health, for example, in the prevention, early detection, and treatment of disease, the management of illness, and the optimization of healthcare professionals’ behaviors. Behaviors are part of a system of behaviors within and between people in that any one behavior is influenced by others. Methods for changing behavior may be aimed at individuals, organizations, communities, and/or populations and at changing different influences on behavior, e.g., motivation, capability, and the environment. A framework that encapsulates these influences is the Behavior Change Wheel, which links an understanding of behavior in its context with methods to change behavior. Within this framework, methods are conceptualized at three levels: policies that represent high-level societal and organizational decisions, interventions that are more direct methods to change behavior, and behavior change techniques that are the smallest components that on their own have the potential to change behavior. In order to provide intervention designers with a systematic method to select the policies, interventions, and/or techniques relevant for their context, a set of criteria can be used to help select intervention methods that are likely to be implemented and effective. One such set is the “APEASE” criteria: affordability, practicability, effectiveness, acceptability, safety, and equity.
Joseph E. Gaugler, Colleen M. Peterson, Lauren L. Mitchell, Jessica Finlay, and Eric Jutkowitz
Mixed methods research consists of collecting and analyzing qualitative and quantitative data within a singular study. The “methods” of mixed methods research vary, but the ultimate goal is to provide greater understanding and explanation via the integration of qualitative and quantitative data. Mixed methods studies have the potential to advance our understanding of complex phenomena over time in adult development and aging (e.g., depression following the death of a spouse), but the utility of this approach depends on its application. The authors systematically searched the literature (CINHAL, Embase, Ovid/Medline, PubMed, PsychInfo, and ProQuest) to identify longitudinal mixed methods studies focused on aging. They identified 6,351 articles published between 1994 and 2017, of which 174 met the inclusion criteria. The majority of mixed methods studies reported on the evaluation of interventions or educational programs. Non-interventional studies tended to report on experiences related to the progression of various health conditions, the needs and experiences of caregivers, and the lived experiences of older adults. About half (n = 81) of the mixed methods studies followed a sequential explanatory design where a qualitative component followed quantitative evaluation, and most of these studies achieved “integration” by comparing qualitative and quantitative data in Results sections. There was considerable heterogeneity across studies in terms of overall design (randomized trials, program evaluations, cohort studies, and case studies). As a whole, the literature suffered from key limitations, including a lack of reporting on sample selection methodology and mixed methods design characteristics. To maximize the value of mixed methods in adult development in aging research, investigators should conform to recommended guidelines (e.g., depict participant study flow and use recommended notation) and consider more sophisticated mixed methods applications to advance the state of the art.